Acceptability of a technology-supported and solution-focused intervention (DIALOG+) for chronic depression: views of service users and clinicians

Aleksandra Matanov,Victoria Bird,Philip Mcnamee,Nick Barber,Syeda Akther

doi:10.1186/s12888-021-03256-5

Aleksandra Matanov, Victoria Bird + Show 3 more

Open Access

https://doi.org/10.1186/s12888-021-03256-5

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Abstract

BackgroundTreating chronic depression represents a significant burden for the NHS, yet there is a lack of evidence-based interventions and research specifically focused on this condition. DIALOG+, a technology-assisted and resource-oriented intervention found effective for people with psychosis, may improve care for this service user group. The aim of this study was to explore the acceptability and relevance of DIALOG+ for the treatment of chronic depression in community-based settings.MethodsA convenience sample of 16 mental health professionals and 29 service users with chronic depression tested the DIALOG+ intervention in routine community care appointments for 3 months across 3 different mental health NHS Trusts in England. Of these, 15 clinicians and 19 service users were individually interviewed about their experiences. Interview transcripts were analysed using thematic analysis by an analytic team which included a service user researcher.ResultsAnalysis of the combined dataset identified five overarching themes: DIALOG+ Structure; Therapeutic Communication; Reflecting and Monitoring; Empowerment and Powerlessness; and The Impact of Technology. Overall, service users and clinicians were interested in the continued use of DIALOG+ as part of routine care.ConclusionsDIALOG+ was viewed as acceptable by both service users with chronic depression and their clinicians who work in community care settings, albeit with some caveats. Clinician training required significant improvements to address the issues that were referenced, most notably around support with using technology.

Highlights

Treating chronic depression represents a significant burden for the National Health Service (NHS), yet there is a lack of evidencebased interventions and research focused on this condition
In total 29 service users and 16 clinicians used the DIALOG+ intervention over a 3-month period and all of them were invited to take part in a semi-structured interview
The acceptability and relevance of the DIALOG+ intervention for people with chronic depression was investigated by eliciting the views of service users and mental health professionals who tested it for 3 months in community-based settings

Summary

Introduction

Treating chronic depression represents a significant burden for the NHS, yet there is a lack of evidencebased interventions and research focused on this condition. DIALOG+, a technology-assisted and resourceoriented intervention found effective for people with psychosis, may improve care for this service user group. The aim of this study was to explore the acceptability and relevance of DIALOG+ for the treatment of chronic depression in community-based settings. The number of people experiencing depression within the UK is set to increase to 1.45 million by 2026. Despite the availability of a range of treatment strategies for acute episodes of depression, up to 30% of people do not adequately improve and instead go on to develop a chronic disorder [4]. Past research has tended to focus on the treatment of acute depression, resulting in a lack of evidence-based. There is a need to develop interventions that are both clinically and cost-effective and can be routinely implemented within different clinical settings

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